Evaluation of adherence in patients prescribed long-acting injectable antipsychotics: A comparison of biweekly versus monthly administered neuroleptics

Abstract

Background:Long-acting injectable antipsychotics (LAIAs) have been developed to decrease medication nonadherence. LAIAs are usually given biweekly or monthly, with the exception of new 3-month and 6-week formulations. There has been no known evaluation regarding whether the frequency of LAIA formulation affects adherence. The purpose of this study is to evaluate whether there is a difference in adherence between LAIAs administered biweekly or monthly.Methods:Eligible participants were identified from the Louis Stokes Cleveland VA electronic medical record as having an active prescription for a LAIA between September 1, 2009, and September 1, 2014. Participants were then evaluated using inclusion and exclusion criteria to determine study entrance. Medication possession ratios (MPRs) were calculated for each participant to determine adherence for comparison of objectives. Descriptive statistics and t tests were used to identify significant differences between groups.Results:There were 128 participants enrolled based on eligibility criteria. There were no differences in MPRs for biweekly versus monthly administered LAIAs (0.98 versus 0.97, respectively; P = .691). No differences in adherence were observed between first- and second-generation LAIAs (0.98 versus 0.98, respectively; P = .975), or for risperidone LAI versus paliperidone palmitate (0.97 versus 0.99, respectively; P = .269). Hospitalizations were observed to decrease by 61% after LAIA initiation (P = .021).Discussion:Based on the findings of this retrospective cohort review, there was no difference in adherence in patients prescribed biweekly versus monthly injected LAIAs. Patient preference and response, safety, tolerability, cost, and availability of follow-up appointments should be other factors to take into consideration for agent selection.

Sociodemographic and clinical factors associated with prescription of first- versus second-generation long-acting antipsychotics in incarcerated adult males

“…In addition, at least three considerations can be expressed. First, in line with our findings, haloperidol represents the most frequently administered compound in some community based-studies (Carr et al ., 2016; Grover et al ., 2019; Auxilia et al ., 2023). Nevertheless, it should be noted that available literature shows contrasting data about the preferential prescribed compound among LAI antipsychotic medications (Reymann et al ., 2022), in the light of different study methods and local factors (Barbui et al ., 2020).…”

High Rate of Discontinuation during Long-Acting Injectable Antipsychotic Treatment in Patients with Psychotic Disorders

“…Even though the available literature shows contrasting data about the preferential prescribed compound among LAI antipsychotics [15,31], guidelines do not provide recommendations on which LAI should be selected, suggesting that the same criteria recommended for the choice of an oral antipsychotic be taken into account. Notably, haloperidol was found to represent the most frequently administered compound, in line with previous reports [34,35]. Taking into account real-world data from recent studies, to the best of our knowledge, this is the first study showing higher prescription of haloperidol decanoate as compared to other LAI antipsychotics.…”

<p>Clinical relevance of paliperidone palmitate 3-monthly in treating schizophrenia</p>

“…From a patient’s perspective, a formulation like PP3M is advantageous, as they need to visit clinics less frequently for injections, especially benefiting patients who are away from home or traveling, etc. As studies have shown a lack of any significant adherence advantage with monthly injected LAIs, it is important to investigate correlations between observed patient preference and positive attitudes on measurement of actual medication adherence in patients using PP3M 113…”